One Step Implants?

Hi, Momof6littles. I had what I believe you are referring to as "one-step implants." Do you mean the expanders/implants are left in, expanded then the port removed? Do you know what brand or who the manufacturer is of the one-step?

The reason I ask these questions is that I did have Becker implants by Mentor back in 2002 that sound similar to what you are describing. It is my understanding these types are not really used anymore. This was a long time ago for me, so I would imagine things have changed, especially since silicone was banned at the time of my dx, except in clinical eval situations. The implant itself had a silicone layer with the saline underneath. Saline was injected into the ports along the side of my body - the ports were hardly noticeable. Once my breasts were the size I wanted, the ports were removed (a very simple procedure ) and I was essentially done...for 10 years.

I was very pleased with the result of the Beckers coming out of surgery, the "pumpings" were fine and the port removal was easy. As far as the tightness, I felt lots of tightness after each pumping, but I would imagine that would happen with any type of expander. I never felt pain. The feel of the implant itself was a little "pucker-y," if that is a word, underneath the breast, but I was told that is pretty normal for saline implants. Overall, the experience was fine, particularly because I was able to minimize the number of surgical procedures.

Unfortunately, in 2012, almost 10 years to the day, my one implant ruptured. Unlike what I expected from a rupture (I thought the ruptured implant would appear like a balloon with no more air), the opposite happened and my breast grew to twice it's size, almost like being engorged. One frantic doctor appointment after another, it was determined I didn't have cancer again and it was an implant rupture with accumulation of water surrounding it. All was fine except I needed new implants. Apparently, the other breast's implant had also ruptured at some point, but I failed to notice it.

This time around, consulting with one of the top plastic surgeons in the Chicago area, I went with all silicone as they "feel more real." Since I hadn't had real breasts in over 10 years, I didn't know what real breasts felt like, but I can say they move a bit more than the saline (on the plus side, I still do not wear a bra). My doc told me the Becker implants were only used for a brief period of time and had a higher than average rupture rate which is why they (plastic surgeons) don't see many of them anymore.

I hope this helped and if you need help generating a list of questions for your plastic surgeon about the one-step, I am happy to help you based on my experience.

Hi Momof6littles, you will need to discuss this with your PS. Sometimes they just can't do everything in one step despite the breast being large. The extent and invasiveness of the underlying mastectomy matter for what PS can/cannot do right after the mastectomy. That is why more often than not they put in the expanders.

mom,

I had one step implants over 4 years ago. You do not have to have large breasts(to the contrary, very large breasted women are not usually considered the best candidates) but you do need to have a skin sparing mx. Regardless of how small you are, if the skin is spared, you can be roughly the same size as before surgery, but perky, not saggy! I was a large B/small C before surgery and am about the same size now. I will say that I did not have a tremendous amount of post surgical pain, but remember, the implant is almost always put under the muscle, so that takes some adjustment on the muscle's part. Tightness is often felt on the underside of the breast since Alloderm or a similar dermal matrix is used to create an internal sling (bye bye under wires!)

I needed no further surgery or revisions. My ps, who was very experienced with one steps, did bring TE's in to the OR and said he would use them if the one steps did not create the right aesthetic look. So, if you are interested in one steps, find a ps who has lots of experience in using them.

Best of luck to you!

I had bilateral nipple sparing, direct to implant surgery. I wouldn't say it was a huge success for me because my breast surgeon was not very experienced ant this is a pretty complicated procedure. I did lose all feeling in both nipples. Have had 5 additional surgeries with implants removed and exchanged and lots of alloderm and fat grafting to try to fix indentations and ripples. Still have some ripples, but it's getting better. Next move (hopefully the last) is to just do some fine tuning and hopefully no more surgery. Good Luck!